Navigating Uncertainty and Unprecedented Shifts in Federal Health Policy

“The amount of chaos that’s been introduced into the federal health policy landscape is unprecedented,” says Michelle Mello, professor at Stanford Law School and the Stanford University School of Medicine.

That turmoil, she explains, has left major gaps in expertise, trust, and leadership—and states are rushing to fill the void. In this episode of Stanford Legal, host Pamela S. Karlan talks with Mello about what this moment means for the future of science, public health, research, and the law.

Mello describes how the hollowing out of career expertise at the U.S. Department of Health and Human Services has upended vaccine policy and research funding, forcing states into unfamiliar leadership roles. She and Karlan also unpack how shifting scientific guidance during the pandemic eroded public confidence, how politicized grant-making is reshaping the research ecosystem, and state governments’ growing role in creating what she calls a “shadow CDC.”

Despite the turmoil, Mello points to a few bright spots: state-level experimentation could generate valuable evidence of what works and what does not, and there are reassuring signs from the lower courts, she says, which she believes are capable of separating law from politics.

Earlier this year, Mello explored many of these themes in her JAMA Health Forum paper, “The Hard Road Ahead for State Public Health Departments.”

Links:

• Michelle Mello >>> Stanford Law page
• JAMA Health Forum paper >>> “The Hard Road Ahead for State Public Health Departments

Connect:

• Episode Transcripts >>> Stanford Legal Podcast Website
• Stanford Legal Podcast >>> LinkedIn Page
• Rich Ford >>>  Twitter/X
• Pam Karlan >>> Stanford Law School Page
• Diego Zambrano >>> Stanford Law School Page
• Stanford Law School >>> Twitter/X
• Stanford Lawyer Magazine >>> Twitter/X
   

(00:00:00) Health Policy and COVID-19 Vaccines

(00:05:10) The Vaccine Rollout Challenges

(00:10:25) Public Trust and Recommendations

(00:16:40) The Role of the Vaccine Committee

(00:23:55) NIH Grant Process Insight

(00:29:43) MIT's Stance on NIH Compact

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